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Journal of Oral & Facial Pain and Headache



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J Orofac Pain 30 (2016), No. 4     28. Oct. 2016
J Orofac Pain 30 (2016), No. 4  (28.10.2016)

Page 355-362

Trismus as a Clinical Manifestation of Tetanus: A Case Report
Papadiochos, Ioannis / Papadiochou, Sofia / Petsinis, Vassilis / Goutzanis, Lampros / Atsali, Charikleia / Papadogeorgakis, Nikolaos
Although the incidence of tetanus disease has radically declined in developed countries, both dental practitioners and oral and maxillofacial surgeons should be knowledgeable about its diagnosis since initial manifestations of the disease, such as trismus and dysphagia, are observed in the orofacial region. This study reports on a case of generalized tetanus diagnosed in a middle-aged man. Before the tetanus diagnosis, the patient had sought medical advice from seven different health care professionals, including a dentist and an oral and maxillofacial surgeon. The patient reported trismus and dysphagia as his main complaints. The suspicion of tetanus emerged from the patient's manifestations in conjunction with his history of trauma and his agricultural occupation. The patient underwent successful treatment including administration of muscle relaxants, antibiotics, and booster vaccination doses of tetanus toxoid as well as a tracheostomy and aided mechanical ventilation. This case report highlights the significance of taking a meticulous medical history, thoroughly performing a physical examination, and systematically assessing orofacial signs and symptoms.

Keywords: diagnosis, lockjaw, tetanus, treatment, trismus